Trial reportInternational journal of general medicine2024
The Effects of Opioid-Free Anesthesia with Dexmedetomidine and Esketamine on Postoperative Anesthetic-Related Complications for Hip Surgery in the Elderly.
Trial report in International journal of general medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07002723 (Effects of Esketamine Combined With Dexmedetomidine on Postoperative Sleep Quality in Elderly Patients Undergoing Hip Surgery), which is not on this map. Cited by 12 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effects of Esketamine Combined With Dexmedetomidine on Postoperative Sleep Quality in Elderly Patients Undergoing Hip Surgery:A Superiority Randomized Controlled Trail
Who cites it
12 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Perioperative dexmedetomidine plus esketamine for postoperative neurocognitive outcomes: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Effects of esketamine on postoperative delirium in adult patients: a systematic review and meta-analysis of randomized controlled trials.Frontiers in neurology · 2026Pooled it
- Effects of dexmedetomidine on perioperative neurocognitive disorders in elderly patients undergoing non-cardiac surgery: a scoping review.Frontiers in neuroscience · 2026Pooled it
- A comprehensive review and meta-analysis on the safety and efficacy of esketamine for emerging delirium in elderly patients.Frontiers in medicine · 2026Pooled it
- The effect of esketamine on postoperative delirium in patients undergoing general anesthesia: a systematic review and meta-analysis.Frontiers in pharmacology · 2025Pooled it
- Subanesthetic S-ketamine prevents postoperative delirium and reduces inflammatory cytokines in older patients receiving hip fracture surgery: a randomized, controlled study.Naunyn-Schmiedeberg's archives of pharmacology · 2026Trial
- Effects of Esketamine-Dexmedetomidine Combination on Immediate Postprocedural Oxygenation Index in Severe Pneumonia Patients Undergoing Bedside Fiberoptic Bronchoscopic Sputum Aspiration: A Prospective Randomised Controlled Trial.Drug design, development and therapy · 2025Trial
- Neuroinflammation in postoperative cognitive dysfunction: the multi-target potential of esketamine in modulating microglial responses and synaptic integrity.Frontiers in molecular neuroscience · 2026Review
- A systematic review and meta-analysis on ketamine use and postoperative delirium in older patients undergoing spine or orthopedic surgery.Anesthesiology and perioperative science · 2026Review
- Progress in the Application of Esketamine During the Perioperative Period.Drug design, development and therapy · 2026Review
- Opioid-free anaesthesia as a valuable alternative to opioid-based practices: evidence and future challenges.Pain management · 2025Review
- S-ketamine plus dexmedetomidine vs. S-ketamine plus propofol for sedation-analgesia during positioning for spinal anesthesia in older adults undergoing lower extremity fracture surgery.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Purpose: The routine perioperative use of opioids has recently been questioned due to opioid-related side effects, which can be potentially harmful in geriatric patients. This study aimed to evaluate the effects of opioid-free anesthesia in geriatric patients undergoing hip surgery. Patients and Methods: A total of 121 patients, aged 60 years or older, undergoing elective hip surgery were randomized to receive either opioid-free anesthesia with dexmedetomidine and esketamine (OFA group) or balanced anesthesia with opioids (CON group). All patients received a preoperative fascia iliaca block and postoperative patient-controlled analgesia using tramadol. The primary outcome was the incidence of a composite of anesthetic-related complications (nausea and vomiting, hypoxemia, ileus, urinary retention and delirium) within 48 hours postoperatively. The hemodynamics, postoperative pain and quality of life were also assessed. Results: The incidence of composite adverse events was significantly reduced in the OFA group compared with the CON group (35.0% vs 62.3%, estimated difference: 27.3%, 95% confidence interval: 10.2%-44.4%, P = 0.003). Notably, patients in the OFA group experienced less postoperative nausea and vomiting (P = 0.040), and hypoxemia (P = 0.025) compared with those in the CON group. However, the incidences of postoperative ileus, urinary retention and delirium were comparable between the two groups. Also, patients in the OFA group had less pain in motion at 24 h postoperatively, as well as less risks of intraoperative hypotension and bradycardia (P <0.05). No significant differences in the postoperative quality of life were observed between the two groups. Conclusion: Opioid-free anesthesia with dexmedetomidine and esketamine reduced postoperative anesthetic-related complications and provided improved hemodynamic stability in geriatric patients undergoing hip surgery.
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